Scoring Systems
T.M. Craft, P.M. Upton in Key Topics In Anaesthesia, 2021
Scoring systems are used in an attempt to predict outcome, improve planning and evaluate care. For a scoring system to be of use it must be able to yield valid, consistent and reproducible results. The validity and reliability of the scoring system must itself be rigorously tested and subjected to peer review. Studies vary as to the accuracy of prediction, as hospital, patient and therapeutic variability will alter risk. More accurate risk determination requires knowledge of the results of the particular hospital. Scores of more than 26 suggest a high incidence of life-threatening complications of cardiac origin. In use the Goldman risk index has proven to be unreliable due to inter-hospital differences, changes in management, and the effect of the operation site and other diseases. Variations in the use of therapies between units affect inter-unit comparisons. Only the Glasgow Coma Score, the systolic blood pressure and the respiratory rate are recorded.
Choosing the Right Venous Access Approach
James Michael Forsyth, Ahmed Shalan, Andrew Thompson in Venous Access Made Easy, 2019
This chapter reviews some realistic and challenging case examples that shows how to apply the venous access assessment in ‘real-world’ settings. It deals with simple cases and work upwards to more complex scenarios. The chapter provides an overview of the venous access options available and the contexts in which they are applicable. A 94-year-old male patient with multiple comorbidities admitted with severe community-acquired pneumonia and acute kidney injury. A 38-year-old otherwise fit and well female patient admitted with lower limb cellulitis that has not improved despite 3 days of oral antibiotics at home. A 49-year-old alcoholic man is admitted onto the acute medical unit with coffee-ground vomiting and bleeding per rectum. He has a systolic blood pressure of 90 mmHg with a heart rate of 110. A 65-year-old gentleman admitted to the emergency department with sudden-onset abdominal and back pain with collapse.
The Acute Stress Response
Rolland S. Parker in Concussive Brain Trauma, 2016
The acute and chronic experience of stress that is comorbid with traumatic brain injury after an accident is psychologically, physiologically, and neurologically different from the condition of the person experiencing stress under other circumstances. The posttraumatic stress reaction or other anxiety-generated condition can be initiated acutely or after recovery of consciousness. Stressors, individual vulnerability, and protective factors result in a complex set of cognitive, systemic, and behavioral responses. Physiological variables include heart rate, skin conductance, electromyogram, systolic blood pressure, and diastolic blood pressure. Thalamic nuclei collaborate with other brain regions involved in arousal, fear, and stress to heighten the salience of information elicited in moderate or controllable stress. The hypothalamus has multiple central nervous system connections with descending autonomic pathways, which originate both from the hypothalamus and various brain stem nuclei. The familiar posttraumatic stress disorder, related to fright and occurring after injury, has well-characterized physiological processes, notably hormonal.
Visits to figurative art museums may lower blood pressure and stress
Published in Arts & Health, 2019
Stefano Mastandrea, Fridanna Maricchiolo, Giuseppe Carrus, Ilaria Giovannelli, Valentina Giuliani, Daniele Berardi
Background The research aimed to assess, through physiological measurements such as blood pressure and heart rate, whether exposure to art museums and to different art styles (figurative vs. modern art) was able to enhance visitors’ well-being in terms of relaxing and stress reduction. Method Participants (n = 77) were randomly assigned to one of three conditions, on the basis of the typology of the art style they were exposed to in the museum visit: (1) figurative art, (2) modern art and (3) museum office (as a control condition). Blood pressure and heart rate were measured before and after the visits. Results Diastolic values of the participants were quite stable, as expected in people who do not suffer hypertension; we therefore considered only variations in systolic blood pressure. The majority of the participants exposed to figurative art significantly decreased systolic blood pressure compared to those exposed to modern art and museum office. No differences were found in the heart rate before and after the visit for the three groups. Conclusion Findings suggest that museum visits can have health benefits, and figurative art may decrease systolic blood pressure.
Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden
Published in Renal Failure, 2016
Carlos R. Franco Palacios, Eric N. Haugen, Amanda M. Thompson, Richard W. Rasmussen, Nathan Goracke, Pankaj Goyal
Background: The target blood pressure in older patients is controversial. Recent studies provided clinical evidence supporting a target systolic blood pressure 50 years at high risk of cardiovascular events. Methods: Retrospective study of 380 consecutive patients ≥60 years with stages 1–5 pre-dialysis chronic kidney disease seen between January 2013 and November 2015. The outcomes of a systolic blood pressure
The Importance of Nose-breathing for the Systolic Blood Pressure Rise during Exercise
Published in Acta Oto-Laryngologica, 1990
Bjorn Petruson, Thorvald Bjurö
The effect of nose breathing on the systolic blood pressure was examined in ten healthy men. Nose breathing was increased above normal by exercise and tested by maximum bicycle ergometry. When the anterior part of the nose was dilated with Nozoventr` the nasal airflow increased by on average 29%. In this condition, all ten men could cycle at maximum load without mouth breathing and there was a significantly lower increase (13 mmHg) in the systolic blood pressure than when the nasal dilator was not used. The reason for this lower blood pressure increase is unknown. The hypothesis is put forward, however, that facilitated nose breathing decreases the respiratory work, which in turn lowers the systolic blood pressure during exercise.